Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuria E. coli 212)

• Published in: Journal of veterinary internal medicine Vol. 38; no. 5; pp. 2548 - 2555
• Main Authors: Segev, Gilad, Chen, Hilla, Dear, Jonathan D., Martínez López, Beatriz, Pires, Jully, Klumpp, David J., Schaeffer, Anthony J., Westropp, Jodi L.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.09.2024; Wiley
• Subjects: Animals; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; anti-infective agents; Antimicrobial agents; antimicrobial resistance; Asymptomatic; Bacteria; bacterial culture; Bacteriuria - drug therapy; Bacteriuria - veterinary; Bladder; blood serum; Catheters; clinical examination; Clinical trials; cystitis; dog; Dog Diseases - drug therapy; Dogs; E coli; Enrollments; Escherichia coli; Escherichia coli - drug effects; Escherichia coli Infections - drug therapy; Escherichia coli Infections - veterinary; Female; Hematuria; Immunoassay; Laboratories; Male; questionnaires; SMALL ANIMAL; ultrasonography; Urinalysis; Urinary incontinence; urinary tract; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - drug therapy; Urinary Tract Infections - veterinary; Urine; Urogenital system; veterinary medicine; urinary tract; cystitis; antimicrobial resistance; dog
• ISSN: 0891-6640; 1939-1676; 1939-1676
• DOI: 10.1111/jvim.17167

Background Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. Hypothesis/Objective Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. Animals Thirty‐four dogs with >1 UTI in the 12 months before presentation. Methods All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. Results Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non‐inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. Conclusions and Clinical Importance These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.